Possible Cure for Common Cold And Other Viral Infections

For real... at least in mice, but has potential for human application if the promise holds out!

MIT researchers have developed a radical new approach to eradicating viral infections no matter what the virus may be... common cold, HIV, Ebola, polio, dengue fever, etc.

The usual anti-viral antibiotics in use today target the viral replication process which unfortunately often fails with time as the virus adapts and develops resistance to the medication.

The new medication dubbed "DRACO" (Double-stranded RNA Activated Caspase Oligomerizers) approaches viral infections using a totally different approach. It is able to IDENTIFY cells infected with the virus and KILLS the cell itself before the virus has a chance to take over the cell and create more virus copies. As such, the virus itself is not targeted, but rather the infected cells themselves instead.

To use an analogy, let's use an ant colony as the "viral infection". Current antivirals work by trying to pick off the Queen Ant or the ants themselves. DRACO works by destroying the entire colony. It doesn't care about individual ants or where they came from. All it cares about is the colony itself and initiates it's entire destruction.

For those more intellectually curious, DRACO is able to identify "double-stranded RNA" (ds-RNA) which is ONLY found in cells infected with a virus. One part of DRACO is able to identify and bind to this unique viral marker. The other part of DRACO is a protein that signals the cell to undergo suicide (apoptosis) thereby preventing the virus from hijacking the cell to make more virus particles. If a virus can't make copies of itself, no infection can occur.

Given ds-RNA is unique to viral infections, DRACO does not care what kind of virus it is (remember, it is not targeting individual "ants" to use the analogy). As such, whether it be the common cold or the dreaded Ebola virus, DRACO kills virus-infected cells indiscriminately. If no ds-RNA is present, DRACO remains inactive and healthy cells remain unharmed.

The tests reported in this study were primarily accomplished in cultured human and animal cells, but researchers also tested DRACO in mice infected with the H1N1 influenza virus. When mice were treated with DRACO, they were COMPLETELY cured of the infection. The tests also showed that DRACO itself is not toxic to mice.

More animal tests are underway and if all goes well... human trials may hopefully occur in the future!

Very promising!

Read a media report on DRACO here.

Reference:
Broad-Spectrum Antiviral Therapeutics. PLoS ONE 6(7): e22572. doi:10.1371/journal.pone.0022572

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New Webpage on Peritonsillar Abscess Added to Website

Our office has created a new webpage on the evaluation and treatment of peritonsillar abscess.

Peritonsillar abscess is when a pus collection develops behind the tonsil causing a severe sore throat and trouble swallowing.

Read more on how this condition is treated here.

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Video of Endoscopic Salivary Stone Removal (Sialendoscopy)

The Doctors TV show actually produced a great (and accurate) segment on a relatively new procedure called sialendoscopy. This procedure allows a surgeon to remove a stone that may be blocking your spit gland from draining saliva into the mouth. This is analogous to a kidney stone which blocks urine from draining from the kidney into the bladder resulting in painful swelling of the kidney (causing flank pain).

How does a person know if they have a salivary gland blockage due to a stone? There is a painful swelling located right in front and/or below the ear if the parotid gland is affected, or under the jawbone if the submandibular gland is blocked.

If the blockage persists long enough, it may lead to an infection of the gland itself (sialadenitis).

Traditionally, if the stone doesn't pass on its own with conservative measures, stone removal required surgical removal of the entire gland or making an incision and removing the stone like it's a tumor mass.

Watch the video of this procedure being performed as shown on The Doctors here.

At this time, the only local surgeon I am aware of who offers this unique procedure in the mid-Atlantic region is Dr. Arjun Joshi.

Dr. Arjun Joshi (George Washington University Hospital in Washington DC)
2021 K St NW, Ste 206
Washington, DC 20006
Office Number: 202-741-3250
www.dcheadandneck.com

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Possible Novel Cure for Cat Allergy?

A research team in Canada has developed a possible cure for patients suffering from cat allergy using a novel type of allergy shot called peptide immunotherapy.

To understand the significance of this development, one needs to understand how traditional allergy shots are made. Currently, allergy companies purify a protein called Fel d1 from cats and make a vial out of it. This purification process is like removing the corn kernels from a cornstalk to put into a can to sell at the supermarket.

Peptide immunotherapy as described in this new research is like making the "essence" of the corn kernel in the lab. For this cat vaccine, the key molecule created is a 7 amino acid long peptide sequence.

The benefits of this novel treatment is the lack of side-effects when the shots are administered (meaning, no waiting around after the shot)... and only four to eight shots per year are required (rather than the weekly injections with current allergy shots).

The optimal dose to use is currently being determined in phase three clinical trials.

Reference:
Development and preliminary clinical evaluation of a peptide immunotherapy vaccine for cat allergy. J Allergy Clin Immunol. 2011 Jan;127(1):89-97, 97.e1-14.

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Home Allergy Shots

DISCLAIMER: This post is not meant to condone or promote allergy shots to be given at home. It is meant to promote discussion and make patients aware of the issues involved.

Allergy shots, unlike medications like claritin and flonase, offer patients with significant allergies a way to potentially be cured of their misery without the need for daily medication use. However, there is a small, but substantial risk for anaphylaxis and even death with allergy shot administration. After all, a patient is being injected with the very substances that cause their allergies. As such, many allergists will allow allergy shots to be administered ONLY within a medical setting. Also, the American Academy of Allergy Asthma and Immunology (AAAAI) specifically forbids allergy shots to be administered at home.

Furthermore, the allergen extracts used to make the allergy vial serum used for allergy shots carry a black box warning on the medication package insert:

"This product is intended for use only by physicians who are experienced in the administration of high dose allergy injection therapy, or for use under the guidance of an allergist. Allergenic extracts may potentially elicit a severe life-threatening systemic reaction, rarely resulting in death. Therefore, emergency measures and personnel trained in their use must be available immediately in the event of such a reaction. Patients should be instructed to recognize adverse reaction symptoms, be observed in the office for at least 30 minutes after skin testing or treatment, and be cautioned to contact the physician's office if symptoms occur. Standardized glycerinated extracts may be more potent than regular extracts and therefore are not directly interchangeable with non-standardized extracts, or other manufacturers' products. Patients with cardiovascular diseases and/or pulmonary diseases such as symptomatic unstable, steroid dependent asthma, and/or those who are receiving cardiovascular drugs such as beta blockers, may be at higher risk for severe adverse reactions. These patients may also be more refractory to the normal allergy treatment regimen. Patients should be treated only if the benefit of treatment outweighs the risks. Patients on beta blockers may be more reactive to allergens given for testing or treatment and may be unresponsive to the usual doses of epinephrine used to treat allergic reactions. This product should never be injected intravenously."

The downside of allergy shots is that they are given 1-2X per week not just for a month or two, but for YEARS. If shots are given only within a medical facility, the patient must commit a significant amount of time, travel, and gas in order to complete a shot series. There is also the time missed from work. In essence, the patient must approach allergy shots like a part-time job.

Given all this... what are the actual risks of anaphylaxis and death from allergy shots?

VERY small...

In one Mayo Clinic study on 79,593 immunotherapy injections over a 10-year period showed the incidence of adverse reactions to be less than two-tenths of 1 percent (0.137 percent). Most of the reactions were mild and responded to immediate medical treatment. There were no fatalities.

More than 1 million injections were given without a fatality to 8,706 patients in allergy clinics at Roosevelt Hospital, New York City, between 1935 and 1955.

Worldwide, there were only 35 deaths reported from allergy shots between 1985 - 1993. It has been estimated that during that period there were 52.3 million immunotherapy procedures, making the incidence of fatality less than one per million (0.6692 per million). Data recently compiled by the Allergen Products Manufacturers Association (APMA) estimated the incidence of fatalities to be about three per 190 million annual injections, or approximately one per 63 million injections.

Now compare this to other medical interventions. Approximately 1 in 5000 exposures to a IV dose of penicillin or cephalosporin antibiotic causes anaphylaxis of which more than 100 deaths per year are reported in the United States. Fatal reactions to penicillin have ranged from 0.4 fatalities per million injections to 1 fatality per 7.5 million injections.

One to 2% of people receiving IV contrast (for a CT scan) experience some sort of systemic reaction. The majority of these reactions are minor, but fatalities have occurred in about 1 in 13,000 to 1 in 75,000 procedures in the 1980s (a more recent study has shown a decrease of 1 fatality in 169,000 procedures).

So... the main question now is should home allergy shots ever be allowed?

There are two ways of answering this question.

The first way is to consider any fatality due to an allergy shot (no matter how extremely rare) to be unacceptable, especially when considering the disease being treated -- allergies -- to be a quality of life issue rather than a life/death issue (heart transplant surgery). There is also that black box warning mentioned above.

The other way to view the answer is to consider things in perspective. There are MANY quality of life activities that people perform that has a risk of severe bodily harm if not death. Swimming results in 1,150 deaths per year in the United States alone. There are about 43,000 fatalities per year from car accidents.

Also, if one takes the stringent view that any fatality due to an allergy shot to be unacceptable, than patients should be monitored in a medical facility for not just 30 minutes or less, but 24 hours as late reactions can still occur the following day after an allergy shot! Indeed, in England, patients are required to wait under observation for anaphylaxis as long as ONE HOUR after each and every injection!!! In fact, the one hour observation was an improvement over the TWO hours that was imposed initially. Read more about this here.

So why draw the line at 20 minutes (or more) as recommended by the AAAAI in the United States? It's because the vast majority of severe reactions occur within the first 30 minutes. Beyond 30 minutes, severe reactions become less common (but NOT zero). Well, severe reactions are not very common to begin with... and if allergy shots must be given in a medical facility due to this concern... than should it not follow logically that no matter how rare the possibility, that patients MUST be observed for 24 hours no matter how small the risk of anaphylaxis than?

Why state that allergy shots must be given in a medical facility due to small, but possible risk of severe reaction on the one hand, and than state that there is a small, but acceptable risk of severe reaction after 20+ minutes of observation in a medical facility?

It is just through this thought process that some physicians who provide allergy shots allow home injections. At this time, it is estimated that about 15% of allergists allow home injections (based on a blinded survey of allergists).

IF home allergy shots are allowed (and this is by no means a recommendation or a statement condoning home allergy shots, but just saying in a hypothetical sense), it should be done only in carefully selected patients:

- Are on maintenance regimen (allergy shots are not being increased)
- No significant reactions during buildup and maintenance
- Proper training in administration (just like diabetics are trained to give themselves their shots)
- Epi-pen available and understanding in how to use
- In-office allergy shot with post-injection monitoring for a period of time with every new vial
- Only in adults
- CONSENT signed by patient informing of the risks as well as black box warning



References
Systemic reactions to immunotherapy at the Mayo Clinic. J Allergy Clin Immunol 1997; 99:S66.

The risk of inducing constitutional reactions in allergic patients. J Allergy 1957; 28:251-261.

Deaths associated with allergenic extracts. FDA Medical Bulletin 24, May 1994.

Allergenic extracts used in immunotherapy fatalities. J Allergy Clin Immunol 1997; 99:S67.

Nature and extent of penicillin side-reactions with particular references to fatalities from anaphylactic shock. Bull WHO 1968; 38:159.

Mortality during excretory urography: Mayo Clinic Experience. AJR 1982; 139:919-922.

Reactions to ionic and nonionic contrast media: A report from the Japanese Committee on the Safety of Contrast Media. Radiology 1990; 175:621-628.

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New Anti-Snoring Device... aveoTSD

I received in the mail today a new device called aveoTSD anti-snoring aid by Glidewell Laboratories.

According to the literature, the way it works is by advancing the tongue forward thereby preventing the tongue from falling backward and vibrating against the throat's back wall causing snoring as well as obstructive sleep apnea.

The way the device moves the tongue forward is by literally suctioning the tongue tip into the device and holding it in place by vacuum seal.

The theory behind how this device works is sound and mimics what an oral appliance does as well as several surgical procedures including base of tongue reduction, hyoid advancement, and Repose procedure.

The one caveat I have with this device is that it only resolves snoring due to the tongue. It would not necessarily address snoring that comes from the nose or palate. There are other devices/surgeries that would address those areas (breath-rite strips, Pillar procedure, UPPP, septoplasty, etc).

I lied... there's another caveat... Will the suction vacuum hold all night for a patient??? It does come in several different sizes... but still...

Read more about the aveoTSD here.

Read more about snoring here.

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Bottles / Vials for Allergy Drops (Under Tongue) Immunotherapy

We have received a number of requests of where one can obtain allergy vials for use in SLIT (sub-lingual immunotherapy) whereby a drop is placed under the tongue to try and achieve allergy cure. This mode of treatment is an alternative to the more traditional allergy shots.

Our office provides both modes of immunotherapy.

Regarding the allergy vials themselves, you can obtain them from Edge Pharmaceuticals. They offer a number of different vial types as shown in the picture. They range in sizes from 15cc to 20cc and provide 40ul to 200ul drops with each dispensation.

Contact Info:

7264 NW 63rd Terrace

Parkland, FL 33067

Phone: 877-580-3343

Fax: 877-581-3343

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Different Types of Immunotherapy for Allergy Cure

Most people are already familiar with allergy shots and even sublingual (under the tongue) allergy drops as treatment to try and achieve cure (or tolerance) to the things they are allergic to.

However, there are other forms of immunotherapy that may one day provide just as good if not better allergy cure rates. These include (most currently under research):

- Intra-Lymphatic Injections (ILIT): Rather than weekly shots in the arm, one research paper reported only 3 injections into a groin lymph node over 2 months provided equivalent results to allergy shots in the arm after 3 years!

- Allergy Tablets: Potentially in the next year or 2, tablets may become available to treat certain allergies. Grazax by Merck which treats grass allergy is the first which is currently undergoing FDA approval.

- Epicutaneous immunotherapy (EPIT) involves lightly scraping a patient’s skin and then applying a patch that delivers the allergens through the bloodstream.

- Intra-Nasal Spray: Declared effective and safe by WHO.

- Bronchial Inhalers: Marginal effectiveness and risky.

At this time, our office only provides allergy shots and allergy drops.

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Substance That Protects Farm Children From Developing Allergies and Asthma Later In Life Identified

That beneficial substance identified is the plant sugar molecule arabinogalactan. It has been well known for some time that children who grow up on farms are less prone to allergies and allergic asthma. However, just what it is that protects them remained a riddle for a long time until now.

European researchers collected and analyzed stable dust from diverse farms in Germany, Austria, and Switzerland. What they found was arabinogalactan, a large sugar molecule, prevented excessive alertness of the immune system which would have developed into allergies and asthma.

The scientists now plan to investigate whether arabinogalactan can be used as prophylaxis or whether it is also suitable for the treatment of allergies and allergic asthma. It is conceivable that arabinogalactan could be used as spray or nose drops because it is highly water-soluble.

ReferenceArabinogalactan isolated from cowshed dust extract protects mice from allergic airway inflammation and sensitization. J Allergy Clin Immunol. 2010 Jul 9.

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Effective Home Treatment for Benign Paroxysmal Positional Vertigo (BPPV)

A research article was published in July 2010 that found use of a device called "DizzyFIX" had cure rates for BPPV (benign paroxysmal positional vertigo) of ~88% which is similar to standard treatment (Semont and Epley maneuvers) performed by a physician.

Although there are YouTube videos on how to do the Epley and Semont maneuvers correctly, unfortunately, patients rarely do it correctly when doing it privately at home resulting in prolongation of their symptoms.

The "DizzyFIX" device can be used at home and takes the patient through the CORRECT maneuvers to cure them of the dizzy attacks if due to BPPV (Benign Paroxysmal Positional Vertigo).

Watch a video here on how this device works.

Reference
Efficacy of a New Home Treatment Device for Benign Paroxysmal Positional Vertigo. Archives of Otolaryngol Head Neck Surg 136(7):682-683, July 2010.

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One-Size-Fits-All Injection that Can Cure Allergies!

Cytos Biotechnology has recently completed patient trials that suggests that a one-size-fits-all allergy injection can alleviate and potentially cure allergies, asthma, eczema and other allergy conditions including even food allergies!

This innovative medical treatment is known only as CYT003-QbG10. It is composed of pieces of synthetic DNA similar to those found in the bug that causes tuberculosis. The DNA fools the body into thinking it is under attack from a dangerous bug, kick-starting a multi-pronged immune response. The ability of a single formula to protect against more than one allergy suggests the jab is reprogramming the immune system by tackling the root cause of allergies.

Current allergy shots (as well as allergy drops) work by injecting the actual proteins that cause allergy in small doses that are slowly increased. For example, if you are allergic to cat, than actual cat protein is injected into you in slowly increasing amounts over time.

With CYT003-QbG10, there would be no need for allergy testing and in essence, if truly successful, patients can be cured of allergies with this type of vaccination, just like the childhood vaccines have near-eradicated polio, mumps, measles, etc. It is not clear how often the new vaccine would have to be given. But scientists envisage an initial short course of jabs, followed up by a booster session two or three years later.

Large scale human trials are supposed to begin in 2011.

Read more in this media report here.

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